Individual provider Active NPI

Kathryn Spychalski, RD

  • Registered Dietitian
  • Skaneateles, NY
National Provider Identifier
1568189652
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
010720 Issued in NY
Practice address
7 Onondaga St
Skaneateles, NY 13152-1313
Phone
(315) 710-0080
Fax
(844) 364-4235
NPI assigned
Oct 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 010720 NY Primary

Addresses

Primary practice location

7 Onondaga St
Skaneateles, NY 13152-1313

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 423-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221128000237 NY Practitioner - Registered Dietitian Or Nutrition Professional 0042688913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
State University of New York at Buffalo School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kellys Choice LLCGroup PAC ID 7517384464, 4 clinicians

Practice addresses (Care Compare)

7 Onondaga St
Skaneateles, NY 13152-1313
Phone (315) 730-4459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010720NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly'S Choice, LLC Dietitian, Registered CurrentSince Nov 1, 2022 Accepting new patients

Locations

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1568189652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ONONDAGA ST",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131521313",
            "telephone_number": "315-710-0080",
            "fax_number": "844-364-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPYCHALSKI",
        "first_name": "KATHRYN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "010720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skaneateles, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.